| Doctor Name: | SHAE RAY |
| NPI Number: | 1003275959 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R67104 |
| Business Practice Address: | 4005 High Resort Blvd Se Rio Rancho, NM - 871245906 |
| Business Phone Number: | 5054626000 |
| Business Fax Number: | |
| Mailing Address: | 4005 High Resort Blvd Se, RIO RANCHO |
| State: | NM |
| Postal Code: | 871245906 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/21/2016 |
| NPI Last Update Date: | 02/21/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP2201X |
| License Number: | R67104 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Ambulatory Care |
| Taxonomy Definition: | |